BELLINGHAM COSMETIC DENTISTRY

WHAT IS COSMETIC DENTISTRY?

The common perception of cosmetic dentistry is that it’s all about specialized restorations on front teeth, such as veneers. Yes, veneers and tooth whitening are common treatments within the realm of cosmetic dentistry, but cosmetic dentistry is much more than this. I start with a good understanding of what the patient doesn’t like about their smile. It’s very important to listen to patient’s concerns and understand what they are trying to communicate. In most cases, it’s more than just the shape or color of the teeth affecting the attractiveness of a smile. My job is to illustrate these aspects of the smile that could be changed in order to improve it. Some examples of things my team and I look at to evaluate the esthetics of one’s smile are:

  • Gum levels around the teeth and gum display while smiling
  • Tooth spacing
  • Shapes and proportion of individual teeth
  • The position of the teeth relative to the lips
  • Tooth color, translucency, and opacity
  • Degree of tooth wear
  • Facial proportion and profile as they relate to the dental arches

Once we’ve evaluated all aspects of esthetics, I explain what treatments are available and what the pros and cons are for each treatment. The general categories of dentistry we often use in treating cosmetic cases are:

  • Restorative techniques of general dentistry, such as veneers, crowns, and bonded fillings
  • Orthodontics
  • Periodontal surgery (gum surgery)
  • Oral surgery (implants and jaw surgery)

EXAMPLES OF COSMETIC DENTISTRY PROCEDURES:

A. Restorative Dentistry Procedures

     i) Porcelain Veneers: ultra-thin ceramic facings that allow reshaping and/or lightening the color of front teeth. Veneers typically affect the front face and edges of teeth and leave the back side intact. Veneers are made in a commercial dental lab and bonded to the underlying tooth structure in a second appointment. For more on veneers, see this post.
     ii) Composite Veneers: tooth-colored filling material that is bonded directly to the front surface of teeth in order to enhance their shape and/or color.
     iii) Crowns: thimble-shaped ceramic tooth coverings used to restore or reshape all surfaces of a tooth. Crowns are sometimes referred to as “caps,” due to their hat-like shape. For more on crowns, see this post.
     iv) Tooth Whitening: whitening is sometimes referred to as “bleaching,” although household bleach (sodium hypochlorite) is never used. Whitening works by chemical removal of stains from the surface and from within the tooth structure. The chemicals—either carbamide peroxide or hydrogen peroxide—are applied to the teeth in gel form, using a soft plastic carrier called a “tray.” In some circumstances, a light or laser may be used to enhance the chemical reaction of the gels, thus speeding up the process. More concentrated whitening gels require a protective mask over the gum tissue to protect them and are only applied in a dental office, as opposed to a home-use system which uses less concentrated gels. For more on teeth whitening procedures, see this post.
     v) Diastema closures: a “diastema” is a gap between two teeth. Sometimes patients want this space closed, especially diastemas between the upper front teeth. Although these spaces are sometimes best closed by moving the teeth together using orthodontic treatment, they can also be closed using veneers, crowns, or composite filling material.
     vi) Gingivectomies: a gingivectomy is a procedure in which gum tissue is trimmed from around the teeth. This may be done in cases where there is excess gum tissue or when we desire a change in the gum level around the teeth. Gingivectomies can be done with a soft tissue laser, electro-cautery, or with a scalpel blade.
     vii) Dental implants: threaded inserts placed into the jaw that replace the root of a single tooth or support a dental prosthesis, such as a bridge or a denture. Although dental implants are not always considered a cosmetic procedure, they are when used to replace missing front teeth. In this case of a single implant, they become an anchoring device for a ceramic crown. The majority of dental implants are made of titanium metal alloy, however, some are made of a ceramic material called zirconia.

B. Procedures Usually Done In Specialty Dental Practices

    i) Esthetic crown lengthening: when the gum line needs to be moved, or when teeth are too short to be restored with crowns, this surgical procedure becomes necessary.
    ii) Orthodontics: most orthodontic treatment is done on teenagers right after adult teeth have erupted, but sometimes orthodontic treatment is necessary for adults. There are numerous ways that orthodontists can assist general dentists in treating cosmetic cases. They include:
– Fixing crowded teeth
– Helping to create wider arches (may be done in co-operation with an oral surgeon)
– Uprighting of tipped teeth
– “Forced eruption” of teeth broken at the gum line so that they can be restored
– Moving teeth in order to change gum levels
     iii) Oral surgery: oral surgeons are mostly known as dentists who take out wisdom teeth, however, they can do much more—especially in the realm of cosmetic dentistry. Oral surgeons often work in collaboration with orthodontists to change the size and/or position of jawbones. The procedure is called “orthognathic surgery” and can have a dramatic effect on a person’s facial profile and smile.
    iv) Gum grafting: a gum graft is the transfer of gum tissue from one area of the mouth to another. There are numerous types of gum surgeries, but gum grafts are typically done for the following esthetic reasons:
– Covering exposed root surfaces
– Correcting ridge deformities, typically where there is missing bone
– Making gums healthier around dental implants

WHY MIGHT SOME PATIENTS WANT COSMETIC DENTISTRY?

Patients usually seek cosmetic dentistry because there’s something about their smile they don’t like. Some of the most common concerns I hear from my patients relate to:
– Crowding or shifting of teeth
– Chipping or breakage of teeth
– Dark tooth colors and stains
– Crowns or fillings that don’t look realistic
– Teeth that don’t feel right or affect speech
– Previous cosmetic dentistry “gone bad”
– Missing teeth
– Broken or decayed teeth
– Teeth damaged by trauma, eating disorders, or drug abuse

WHAT ARE THE BENEFITS?

The primary benefit of cosmetic dentistry is improved self-esteem. There are many secondary benefits as well. When we have boosted self-confidence, we take better care of our general health, we exercise more, we eat better, and all of those things together may even lead to greater financial wellbeing. Improving the esthetics of a person’s smile also re-establishes the beauty that nature simultaneously creates with good function. In other words, a perfect smile is also a mouth with proper function, and proper function enhances the longevity of our teeth.

WHAT’S THE DIFFERENCE BETWEEN COSMETIC SURGERY AND GENERAL DENTISTRY?

Cosmetic dentistry has always been a part of general dentistry. There is a misconception that cosmetic dentistry is a specialty of dentistry that requires different training. Some general dentists are more skilled at the cosmetic aspects of general dentistry, and perhaps do a great job of marketing those skills. Most dental schools only have enough time in their programs to teach the basics of cosmetics, therefore those general dentists who focus their practices on cosmetic procedures must invest time learning additional techniques after they’ve graduated. This learning must be an ongoing process to be truly skilled, as techniques are constantly evolving and improving. Depending on how a dentist wants to focus their practice and what their skill set happens to be, cosmetic dentistry may be a very small part of a general dentist’s practice or almost the entire practice. For practical purposes, we really can’t limit our practices to only cosmetic procedures. Cosmetic dentistry is a huge part of my practice and my knowledge of cosmetics is in constant flux, as I devote hundreds of hours for continuing education to studying this subject matter.

WHAT IS THE PROCEDURE LIKE?

Please see our patient education page for video links to the dental procedures we offer at Northside Dental Care.

DOES COSMETIC DENTISTRY HURT?

One of our primary goals is to have every patient feel comfortable and well cared for. Therefore, we recommend anesthetic for any procedures which may otherwise elicit pain or discomfort. Some procedures, however, require no anesthetic at all.

WOULD I EVER BE DENIED THIS PROCEDURE?

We want to provide services to patients that satisfy their complaints/concerns so that they remain in our practice and tell others of their positive experiences at our office. If we feel that we would be unable to satisfy a patient’s esthetic desires or demands, we may refer them to another office that is better equipped to help them.